Campaigns Offer a Healthy Way Out for Senegalese MSM   

Viewpoint

Photo of a painted wall mural in Senegal saying "Stop SIDA"

For Senegalese men who have sex with men (MSM), discovering LGBT-friendly health providers is as challenging as finding housing, securing employment, and coming out. One non-governmental organization is making it easier for vulnerable Senegalese to access health care. The organization – referred to here as NGO – engages key populations facing discrimination because of their social status and operates in two of Dakar’s neighborhoods.

The NGO partners with the National Network of Key Population Associations to assist Senegalese MSM via three education campaigns. Two campaigns emphasize sexual and reproductive health and harm reduction by partnering MSM with 13 local clinics. A third campaign, implemented in 2016, aims to reduce provider discrimination against LGBT Senegalese.

“We think that it’s a problem of stigma because he who is stigmatized, who is discriminated, he lives in hiding,” said an NGO representative managing the campaigns. “There are those who are watching his every move, so he’s scared to go to the hospital. He’s scared to go to the clinic.”

In 2015, Amadou joined Association Prudence, Senegal’s largest LGBT health and human rights advocacy group. He realizes how homophobia among health providers is a barrier to MSM accessing health careTwitter .

“They don’t have the understanding to accept MSM or lesbians to treat us,” Amadou said. “In Senegal, people say that MSM are troublemakers, so they don’t touch us. They don’t see us. They don’t greet us. It wouldn’t be normal for them to treat us.”

Issa recently joined Prudence. He hides his sexuality from his father and also refuses to disclose his sexual orientation to health providers. Outing himself to friends, family, or health providers could lead to violence against MSM.

“When gays have sexually transmitted infections, we’re scared to go to the hospital for treatment,” Issa said. “There are even some hospitals that turn away from gays. When I go to the doctor, I never tell him that I’m gay.”

A disproportionate number of Senegalese MSM suffer from HIV: the prevalence ranges between 38-44% in this key population, but affects less than 1% of the general population in Senegal. Prudence refers HIV-positive MSM to LGBT-friendly health providers, although LGBT-friendly health providers, too, have to closet themselves when delivering services to Senegalese MSM. Although LGBT-friendly health providers are few and far, Lamine used Prudence to find a safe clinic.

“I always want to know my health [status],” Lamine said. “Every three months, I go for testing to also control my health.”

Recently, Amadou represented Prudence at a community discussion in Dakar. The conference fostered a dialogue on HIV/AIDS prevention between key populations, politicians, and religious leaders.

“They don’t have the understanding to accept MSM or lesbians to treat us,” Amadou said. “In Senegal, people say that MSM are troublemakers, so they don’t touch us. They don’t see us. They don’t greet us. It wouldn’t be normal for them to treat us.”

 

“They told us that it’s the LGBT community who is responsible for the AIDS virus spreading throughout Senegal,” Amadou said. “Can you believe that? As if it’s only us who have sexual relationships.”

During the focus group discussions with community stakeholders, he underscored the LGBT community’s role in HIV prevention. Amadou sees how the partnership between Prudence, the NGO, and LGBT-friendly health providers revolutionizes care for the vulnerable because it includes members of the Senegalese LGBT community in service delivery.

“I know that not everybody is MSM, but the majority of people fighting this virus are MSM,” Amadou said.

As a part of the third education campaign, the NGO plans to organize a community discussion similar to the conference Amadou attended with Prudence.

“We’re organizing debates with the community that are composed of religious leaders and doctors,” the NGO representative said. “I think that it’s important because if these leaders are informed, then they’ll return and inform everyone else.”

The education campaigns help foster a dialogue around the need for LGBT-friendly health providers by engaging MSM and community leaders in Senegal.

“We try to work with these key populations so that they can live their sexual orientation without being an object of stigma, discrimination, and persecution because there are those who are persecuted,” the NGO representative said.

Cheikh, another member of Prudence, was beaten by onlookers after attending a friend’s birthday party in Pikine. The police outed him to his family, and he fears seeking health services because of the stigma associated with identifying as MSM.

“We need everything,” Cheikh said. “We need to live like everyone else. When everyone else is sick and they go to the hospital, they’re treated like Senegalese citizens. Here, we’re not.”

Editor’s note – The NGO is unidentified and the informants’ names are changed to protect their safety.   Interviews were conducted in French and translated to English.

This is part three in a series about LGBT health in Senegal. Click here for parts onetwo and four.

Image: HPIM1525 by Xavier Damman, used under CC BY/cropped from original

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